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Direct Deposit Form

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Phone: 803.684.7359 | Fax: 803.684.0895
221 California Street, York, South Carolina 29745
YorkHASC.org

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Fields marked with * must be filled out for form will not submit

If you prefer to print this form, please complete and return to: 
York Housing Authority
221 California Street
York, SC 29745

If you wish to complete this form online, please fill out and submit below.

Part 1: Transaction Type

Check the appropriate box(es).

NOTE: The payee must review Part 2 and complete Part 3 for all Transaction Types

NEW SETUP - Select if the payee is not currently on direct deposit.

  • The payee or financial institution representative must complete Part 4.

CANCELLATION - Select if the payee wants to stop direct deposit.

  • Do not complete Part 4.

CHANGE FINANCIAL INSTITUTION

  • The payee or NEW financial institution representative must complete Part 4.

CHANGE ACCOUNT NUMBER

  • The payee or financial institution representative must complete Part 4.

CHANGE ACCOUNT TYPE

  • The payee or financial institution representative must complete Part 4.